Objective To investigate the effect of inhaled corticosteroid (ICS) on lung function and inflammatory mediators in cough variant asthma (CAV).Methods Fifty patients with CVA were randomly divided into group A (n =30) and group B (n =20),and 20 normal cases were recruited as healthy group (group C) in this study.All the cases were given a lung function test,bronchial dilation test(BDT) and serum levels of inflammatory mediators(interleukin(IL)-5,IL-8 and IL-10) assessment.The cases in group A were given longterm ICS intervention therapy of inhaled budesonide aerosol at dose of 200 μg/day with 6 months' follow-up period.The cases in group B and C were given salbutamol and symptomatic treatment if necessary.Assessment about lung function (forced vital capacity (FVC),1 s forced expiratory volume (FEV1),peak expiratory rate (PER) and maximum mid-expiratory flow rate(MMEF)),BDT,and inflammatory mediators in all groups were performed before and after treatment.Results (1) Lung function:before treatment,the level of FVC,FEV1 and PEF in three groups were not significantly different (P ＞ 0.05).MMEF in group A and B is significantly lower than that in group C (F =58.40,P ＜ 0.05).In group A,MMEF was significantly improved (P ＜ 0.05,P ＜ 0.01) after 3 and 6 months ICS treatment.In group B,MMEF was not statistical improvement compared with before treatment(P ＞0.05).The BDT positive rate in group C was significantly lower than that in group A and B.The BDT positive rate in group A decreased after ICS treatment for 3 and 6 months.Meanwhile,the BDT level decreased as the longer treatment.In group B,there was no statistical decrease in terms of BDT positive rate(P ＞0.05).(2)Inflammatory mediators:in group C,the serum levels of IL-5 and IL-8 were lower than those in group A and B,but the level of I L-10 was higher than it in the other two groups(P ＜0.05).After 3 and 6 months ICS treatment,the serum levels of IL-5 and IL-8 were significantly decreased and the level of I L-10 was increased.The longer course was given,the more obvious change they have.There was no statistical difference in group B after 3 to 6 months treatment.It was statistical difference between group A and group B after 3 to 6 months treatment (P ＜ 0.05).Conclusion ICS treatment can significantly improve lung function and inflammatory mediators in patients with cough variant asthma.The better improvement will get if the longer treatment is given.

Objective To investigate the influence to airway responsiveness by using low dose azithromycin in asthmatic children.Methods One hundred and four children with moderate persistent or severe persistent asthma were divided into Group A (include 56 cases) and Group B (include 48 cases) randomly.All of the patients were treated with seretide (50/100 μg/dose) 2 doses/d for4 weeks.Children with severe persistent asthma were added with montelukast 5 mg/d orally,children accompanied with allergic rhinitis were added with nasonex 100 ～200 μg/d intranasal.And four weeks later,all of the patients were given a 12-week observation.Group A kept on treating with seretide (the same dose as before),and azithromycin 7.5mg/ (kg·d) (the maximal dose was 250 mg/d) orally was administered intermittently twice a week.Group B kept on treating with seretide ( the same dose as before) only.At the end of the study,we assessed the number of days with asthmatic symptoms in two groups respectively.At the beginning and the end of the study,we measured the forced expiratory volume in one second (FEV1 ％ ),peak expiratory flow (PEF％),the PD20-FEV1 by histamine challenged at the 15 th day and at the end of the study in two groups.Twenty-four hours before the study and twenty-four hours after the study,we measured the 24-hour urinary 17-OHCS and 17-KS of the patients.Two weeks after the study,we measured the serumal ALT and AST of the patients.Results ( 1 ) The number of days with asthmatic symptoms was ( 2.13 ± 1.18 ) d and ( 2.25 + 1.19 ) d respectively in Group A and B,and there was no significant difference between two groups ( t =0.54,P=0.59).(2) The PEF％ before and after the study in Group A was (49.77 ± 15.02)％ and (82.73 ±7.81 ) ％ respectively ( t =16.59,P =0.000).The PEF％ before and after the study in Group B was (52.69±13.90)％ and (81.15±7.28)％ respectively (t=12.37,P=0.000).The FEV1％ before and after the study in Group A was (50.48 ± 15.08 ) ％ and ( 83.18 ± 6.61 ) ％ respectively ( t =16.25,P =0.000).The FEV1 ％ before and after the study in Group B was ( 53.29 ± 13.89 ) ％ and ( 82.73 ± 6.10 ) ％ respectively (t=12.83,P=0.000).(3) The PD20-FEV1 at the 15 th day and at the end of the study in Group A was (65.13 ±26.08) μg and (460.79 ±221.72) μg respectively (t =13.54,P =0.000).The PD20-FEVt at the 15th day and at the end of the study in Group B was ( 65.27 ± 25.75 ) μg and (65.66 ± 25.09 ) μg respectively (t =1.45,P =0.15).Compared the PD20-FEV1 between the two groups,there was significant difference at the end of the study (t =13.29,P =0.000).(4) The 24-hour urinary 17-OHCS was (14.27 ±3.41)nmol/L and (14.43 ±3.69) nmol/L respectively of Group A and was (14.31 ±3.66)nmol/L and ( 14.56 ± 3.37 ) nmol/L respectively of Group B before and after the study,and there was no significant difference between Group A and Group B.The 24-hour urinary 17-KS was ( 22.43 ± 5.69 ) nmol/L and (22.07±5.21 ) nmol/L respectively of Group A and was (22.40±5.04) nmol/L and (22.54 ±4.74)nmol/L respectively of Group B before and after the study,and there was no significant difference between Group A and Group B.(5) The serumal ALT of Group A and B measured 2 weeks after the study was (20.39± 9.12) U/L and ( 20.83 ± 7.83 ) U/L respectively ( t =0.26,P =0.79 ).The serumal AST of Group A and Group B measured 2 weeks after the study was (20.68 ±8.67) U/L and (21.44±8.60) U/L respectively (t =0.45,P =0.66 ).Conclusion It can significantly decrease the bronchial hyperreactivity of asthmatic children treated with low dose azithromycin orally for 12 weeks and seretide inhaled,but it can not decrease the number of days with asthmatic symptoms in the patients,can not improve the FEV1 and PEF significantly.There wasn't any influence on adrenal glands.function and liver function of the patients.

Both dysfunction of pancreatic β cells and β cells apoptosis were important factors contributing to type 2 diabetes. Abnormal glucose and lipid metabolism all existed in type 2 diabetes .With the study further progressing, more and more attention were paid to pancreatic β cells apoptosis accelerated by abnormal lipid metabolism. The literature about β cells injury by lipotoxicity, apoptosis induced factors accompanied by free fatty acids, and relevant mechanism was reviewed in this article.

Objective To explore the role of brain-derived neurotrophic factor (BDNF) in pathogenesis of autism. Methods 12.5 d pregnantWistar rats were injected sodium valproate (VPA) 600 mg/kg or normal saline (NS). Their newborn rats were observed ethologically.The expression of BDNF was measured in their temporal cortex with immunohistochemical stain. Results Compared with NS group, VPAgroup expressed less body mass (P<0.05), eyes opening delay (P<0.05), poorer coordination response (P<0.05), slower taxis response (P<0.05). The number of social behavior decreased (P<0.05), latency increased (P<0.05), duration shortened (P<0.05), repetitive activities increased(P<0.05). Purkinje cells reduced in cerebellum. The expression of BDNF increased significantly in temporal cortex 1 d, 7 d and 14 dpostnatally (P<0.01), but decreased 35 d and 49 d postnatally (P<0.01). Conclusion BDNF plays a role in the pathogenesis of autism.

Objective To investigate the understanding level of asthma related knowledge and the treatment compliance in parents of children with asthma in Tianjin. Methods Questionnaire survey was given to 93 randomly selected parents of children with asthma at our asthmatic clinic ,whose children began to receive regularly asthmatic administration for at least 6 months from June to July in 2009. Results 72.04% of the parents included into the survey knew that asthma was a chronic airway inflammatory disease; 100% of them adhered to use prescription inhaled corticosteroid (55.91%) or inhaled corticosteroid combined with an inhaled long-acting β2-agonist (44. 09% ) ;74. 68% of them believed that if the child is in a well control state, he/she could participate in exercise as healthy children. There were 93.55% and 97.85% children patients aged ＞ 5 had never used PEF meter or CACT respectively to monitor the ill conditions. 25.81% of the parents chose rapid-acting β2-agonist to deal with asthma at acute attack stage, while 19.35% chose to add antibiotics and 11.83% were unable to do anything. 43.01% of the parents worried that the long-term use of inhaled corticosteroid would have side effects on the growth and development of their children, although they chose to obey to the doctor's prescription. Conclusions The general understanding of asthma is good in the parents, whose children had received asthmatic administration regularly in Tianjin area,but there are still some weak links exist. The related education may help asthmatic children's parents to master the knowledge of asthma, give them correct recognition of the treatment and prevention of asthma,increase the treatment compliance. This work should be insisted continuously.

Objective To analyze the genotypes of clinical varicella-zoster virus(VZV) isolates in Tibet.Methods The samples of vesicular fluid from patients with chickenpox or zoster were collected to isolate VZV in human embryonic fibroblast cells.Furtherly,the isolated VZV were identified by indirect immunofluorescence assay and the positive ones were continuely cultured in vitro to get their genome DNAs.Then,PCR and nucleotide sequencing were performed on the part of open reading frames 1,21,50,54.To confirm the genotypes of isolated virus strains,the gene sequences obtained from PCR products were compared with that in GenBank of VZV Dumas strains,and their restriction enzyme sites were analyzed via Primer 5.0.Results Ten clinical isolates of VZV were obtained from sixteen specimens,the positive isolation rate was 62.5％.Gene analysis showed that among all the ten clinical isolates of VZV in Tibet,three strains are genotype A1,four are genotype A2 and the other three are genotype J1.Conclusion The VZV genotype distribution in Tibet was tightly related to their special geographic locations.

AIM:To explore the association between single nucleotide polymorphism in exon 33 (E33SNP) of thyroglobulin gene and Graves ’ disease ( GD) relapse after antithyroid drug ( ATD) withdrawal .METHODS:The healthy controls (232 cases) and GD patients with discontinued treatment (243 cases) were selected.According to the time of re-lapse, the GD patients were divided into A, B and C subgroups.The A group contained 77 cases of relapse within 1 year, B group contained 86 cases of relapse 1~2 years after treatment and C group contained 80 cases without recurrence within 2 years.The genotypes of E33SNP were identified by RT-PCR.The genotype ratio of thyroglobulin between control group and observation group was comparatively analyzed , and the levels of thyroid-stimulating hormone ( TSH) , free triiodothyro-nine (FT3), free thyroxine (FT4) and thyrotropin receptor antibody (TRAb), ophthalmopathy and goiter size in A , B and C subgroups in different genotype GD patients were investigated .Moreover , cumulative efficiency for patients with different genotypes in the observation group after ATD treatment within 2 years were analyzed .RESULTS:The genotype of E33SNP between observation group and control group had no significant difference , but a significant difference between A , B and C subgroups was observed (P<0.05).The levels of TSH, FT3 and FT4, and goiter size of the patients with different geno-types had no significant difference , while the TRAb levels and ophthalmopathy presented a significant difference ( P <0.05).In addition, the cumulative efficiency within 2 years for GD patients with E33SNP T/T, E33SNP T/C and E33SNP C/C genotypes was 61.8%, 42.6% and 21.3%, respectively, all with significant differences (P<0.05).CONCLU-SION:The GD patients with E33SNP C/C genotype have significantly higher TRAb level and ophthalmopathy rate than those in the patients with E33SNP C/T and E33SNP C/C genotypes, and are more likely to relapse after ATD treatment . The GD patients with E33SNP T/T genotype show a lower recurrence rate .Therefore, combination treatment or other treat-ment modalities may be more reasonable for the GD patients with E 33SNP C/C genotype.

Objective To investigate AXIN2 mRNA expression level in hepatocellular carcinoma (HCC) , and to analyze the effect of AXIN2 gene methylation status on its mRNA expression and HCC genesis and development. Methods Fifty-three surgical excised HCC specimens and paired adjacent non-cancerous specimens, seven normal liver specimens and five HCC cell lines were collected. The expression of AXIN2 at mRNA level and the methylation status of AXIN2 gene promoter were determined by quantitative PCR. Results The expression of AXIN2 mRNA was lower in HCC tissues (0.1629 + 0.0679) than that in adjacent non-cancerous tissues (0. 4155 + 0. 2330), and there was significant difference (Z= -2. 567, P = 0. 010). The methylation level of AXIN2 gene in HCC and adjacent non-cancerous tissues (39. 77% ±3. 89%, and 36. 92% ±2. 81%) was significantly higher than that in normal liver tissues (7. 38% ±2. 40% , t=-3. 663 ,P = 0. 009;t= -4. 591 ,P = 0. 007).AXIN2 gene was hypermethylated in all five HCC cell lines. There was a negative correlation between AXIN2 mRNA expression level and the degree of methylation ( r = -0. 458, P = 0. 032). The methylation level was higher in TNM Ⅲ patients of HCC than that in TNM Ⅰ and Ⅱ patients (P =0.008). Conclusion The down-regulation of AXIN2 gene mRNA expression is correlated with its hypermethylation status. The low expression of AXIN2 mRNA and the abnormal methylation of promoter may be one of the important mechanism of HCC genesis and development.

Allergic disease is the common disease that affects human health and life quality.With the development of flow cytometry, basophil activation test(BAT), as an ex vivo challenge test, has become a new method in the diagnosis of allergic disease that IgE mediates.An important step is to establish a standardized BAT method in order to make it available in clinical applications and to explore the mechanisms of allergy in laboratory.This review focuses on the main principles, clinical utility in the diagnosis and management of allergic disease.

Objective:To understand the present situation of the construction of standardized asthma clinic for children in China, to explore the problems existing in the process of construction, and to promote the healthy development of standardized clinic construction.Methods:The process and current situation of the construction of standar-dized asthma clinics for children in China were reviewed and investigated, and the practical significance of the China Children′s Asthma Action Plan (CCAAP) in the construction of standardized asthma clinics for children was explored.Results:(1)By December 2020, 1 289 standardized asthma clinics for children and 135 regional demonstration centers had been built; 56 training sessions had been held, with a total of 2 560 doctors and 650 nurses trained, covering 2 560 hospitals across the country; and 4 518 patient education sessions were held.Online publicity covers a total of 1 million person-times, with an annual average of 1.33 million patients.(2)CCAAP improved the quality control level of standardized asthma clinic and promoted the standardized management of children.Conclusions:Through process optimization, professional evaluation, individual health education and real-time disease monitoring, standardized asthma clinic for children with asthma can effectively enhance asthma management awareness of children and their parents, improve disease awareness, and promote better control of asthma.It is an effective management model of asthma in children at present, and it is worthy of clinical promotion.CCAAP plays a good role in the construction of standardized outpatient clinic for asthma in children.The construction of standardized asthma clinic for children in China has achieved remarkable results, and the development trend is good in the future.